–455 G/A polymorphism and preprocedural plasma levels of fibrinogen show no association with the risk of clinical restenosis in patients with coronary stent placement

 

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Summary

The effect of preprocedural fibrinogen levels on in-stent restenosis is largely unknown. The –455 G/A polymorphism of the fibrinogen β-gene is associated with baseline plasma level or acute phase increase of fibrinogen. Therefore, we hypothesized that there is a relationship between this polymorphism and pre-procedural fibrinogen level and clinical restenosis at follow-up among patients with coronary stent placement. The GENetic DEterminants of Restenosis (GENDER) project is a multicenter follow-up study that enrolled 3,146 consecutive patients after successful percutaneous coronary intervention. A coronary stent was placed in 2,309 patients. Of these, 2,257 (97.7%) patients were successfully genotyped for the –455G/A polymorphism. Plasma fibrinogen levels were measured at baseline in a subpopulation of 623 stented patients with the von Clauss method and patients were grouped into tertiles according to fibrinogen levels. Primary endpoint was target vessel revascularization (TVR); secondary combined endpoint was defined as death presumably from cardiac causes, MI not attributable to another coronary artery than the target vessel, and TVR. No association was observed between the –455G/A polymorphism and TVR or combined endpoint (p=0.99, p=0.97, respectively). Multivariate regression analysis revealed that the risk of TVR and combined endpoint was not higher for patients in the highest tertile for fibrinogen versus the lowest tertile (RR=0.60, 95% CI: 0.26–1.37 for TVR, RR=0.64, 95% CI: 0.29–1.44 for combined endpoint). In conclusion, the presence of –455G/A polymorphism in the fibrinogen β-gene and preprocedural fibrinogen level is not associated with an increased risk of TVR or combined endpoint in a patient population with coronary stent placement. Therefore, these parameters are not worthwhile for stratifying patients at risk for restenosis prestenting.

• References

• 1 Lowe HC, Oesterle SN, Khachigian LM. Coronary in-stent restenosis: current status and future strategies. J Am Coll Cardiol 2002; 39: 183-93.
  PubMedGoogle Scholar
• 2 Agema WR, Jukema JW, Pimstone SN et al. Genetic aspects of restenosis after percutaneous coronary interventions: towards more tailored therapy. Eur Heart J 2001; 22: 2058-74.
  CrossrefPubMedGoogle Scholar
• 3 Stec JJ, Silbershatz H, Tofler GH. et al. Association of fibrinogen with cardiovascular risk factors and cardiovascular disease in the Framingham Offspring Population. Circulation 2000; 102: 1634-8.
  CrossrefPubMedGoogle Scholar
• 4 Montalescot G, Ankri A, Vicaut E. et al. Fibrinogen after coronary angioplasty as a risk factor for restenosis. Circulation 1995; 92: 31-8.
  PubMedGoogle Scholar
• 5 Ernst E, Resch KL. Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature. Ann Intern Med 1993; 118: 956-63.
  CrossrefPubMedGoogle Scholar
• 6 Heinrich J, Balleisen L, Schulte H. et al. Fibrinogen and factor VII in the prediction of coronary risk. Results from the PROCAM study in healthy men. Arterioscler Thromb 1994; 14: 54-9.
  CrossrefPubMedGoogle Scholar
• 7 Woodward M, Lowe GD, Rumley A. et al. Fibrinogen as a risk factor for coronary heart disease and mortality in middle-aged men and women. The Scottish Heart Health Study. Eur Heart J 1998; 19: 55-62.
  CrossrefPubMedGoogle Scholar
• 8 Benchimol D, Bonnet J, Benchimol H. et al. Biological risk factors for restenosis after percutaneous transluminal coronary angioplasty. Int J Cardiol 1993; 38: 7-18.
  CrossrefPubMedGoogle Scholar
• 9 Hoshida S, Nishino M, Takeda T. et al. A persistent increase in C-reactive protein is a risk factor for restenosis in patients with stable angina who are not receiving statins. Atherosclerosis 2004; 173: 285-90.
  CrossrefPubMedGoogle Scholar
• 10 Otsuka M, Hayashi Y, Ueda H. et al. Predictive value of preprocedural fibrinogen concerning coronary stenting. Atherosclerosis 2002; 164: 371-8.
  CrossrefPubMedGoogle Scholar
• 11 Schumacher M, Eber B, Tiran A. et al. Fibrinogen values in patients with and without restenosis following percutaneous transluminal coronary angiography. Cardiology 1992; 80: 345-8.
  CrossrefPubMedGoogle Scholar
• 12 ‘t Hooft FM, von Bahr SJ, Silveira A. et al. Two common, functional polymorphisms in the promoter region of the beta-fibrinogen gene contribute to regulation of plasma fibrinogen concentration. Arterioscler Thromb Vasc Biol 1999; 19: 3063-70.
  CrossrefPubMedGoogle Scholar
• 13 Leander K, Wiman B, Hallqvist J. et al. The G-455A polymorphism of the fibrinogen Bbeta-gene relates to plasma fibrinogen in male cases, but does not interact with environmental factors in causing myocardial infarction in either men or women. J Intern Med 2002; 252: 332-41.
  CrossrefPubMedGoogle Scholar
• 14 Agema WRP, Monraats PS, Zwinderman AH. et al. Current PTCA practice and clinical outcomes in The Netherlands: the real world in the pre-drug-eluting stent era. Eur Heart J 2004; 25: 1163-70.
  CrossrefPubMedGoogle Scholar
• 15 Ellis SG, Vandormael MG, Cowley MJ. et al. Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Multivessel Angioplasty Prognosis Study Group. Circulation 1990; 82: 1193-202.
  CrossrefPubMedGoogle Scholar
• 16 Cheng S, Grow MA, Pallaud C. et al. A multilocus genotyping assay for candidate markers of cardiovascular disease risk. Genome Res 1999; 9: 936-49.
  CrossrefPubMedGoogle Scholar
• 17 Barcellos LF, Begovich AB, Reynolds RL. et al. Linkage and association with the NOS2A locus on chromosome 17q11 in multiple sclerosis. Ann Neurol 2004; 55: 793-800.
  CrossrefPubMedGoogle Scholar
• 18 Clauss A. Rapid physiological coagulation method in determination of fibrinogen. Acta Haematol 1957; 17: 237-46.
  CrossrefPubMedGoogle Scholar
• 19 Li W, Nyholt DR. Marker selection by Akaike information criterion and Bayesian information criterion. Genet Epidemiol 2001; 21 (Suppl. 01) S272-S277.
  CrossrefPubMedGoogle Scholar
• 20 Behague I, Poirier O, Nicaud V. et al. Beta fibrinogen gene polymorphisms are associated with plasma fibrinogen and coronary artery disease in patients with myocardial infarction. The ECTIM Study. Etude Cas- Temoins sur l'Infarctus du Myocarde. Circulation 1996; 93: 440-9.
  CrossrefPubMedGoogle Scholar
• 21 Volzke H, Grimm R, Robinson DM. et al. Candidate genetic markers and the risk of restenosis after coronary angioplasty. Clin Sci 2004; 106: 35-42.
  CrossrefPubMedGoogle Scholar
• 22 Holm B, Nilsen DW, Kierulf P. et al. Purification and characterization of 3 fibrinogens with different molecular weights obtained from normal human plasma. Thromb Res 1985; 37: 165-76.
  CrossrefPubMedGoogle Scholar
• 23 Heinrich J, Funke H, Rust S. et al. Impact of polymorphisms in the alpha- and beta-fibrinogen gene on plasma fibrinogen concentrations of coronary heart disease patients. Thromb Res 1995; 77: 209-15.
  CrossrefPubMedGoogle Scholar
• 24 Scarabin PY, Bara L, Ricard S. et al. Genetic variation at the beta-fibrinogen locus in relation to plasma fibrinogen concentrations and risk of myocardial infarction. The ECTIM Study. Arterioscler Thromb 1993; 13: 886-91.
  CrossrefPubMedGoogle Scholar
• 25 Carter AM, Mansfield MW, Stickland MH. et al. Beta-fibrinogen gene-455 G/A polymorphism and fibrinogen levels. Risk factors for coronary artery disease in subjects with NIDDM. Diabetes Care 1996; 19: 1265-8.
  CrossrefPubMedGoogle Scholar
• 26 Green F, Hamsten A, Blomback M. et al. The role of beta-fibrinogen genotype in determining plasma fibrinogen levels in young survivors of myocardial infarction and healthy controls from Sweden. Thromb Haemost 1993; 70: 915-20.
  Article in Thieme ConnectPubMedGoogle Scholar
• 27 Wang XL, Wang J, McCredie RM. et al. Polymorphisms of factor V, factor VII, and fibrinogen genes. Relevance to severity of coronary artery disease. Arterioscler Thromb Vasc Biol 1997; 17: 246-51.
  CrossrefPubMedGoogle Scholar
• 28 Weng X, Cloutier G, Genest , Jr J. Contribution of the –455G/A polymorphism at the beta-fibrinogen gene to erythrocyte aggregation in patients with coronary artery disease. Thromb Haemost 1999; 82: 1406-11.
  Article in Thieme ConnectPubMedGoogle Scholar
• 29 Chan AW, Bhatt DL, Chew DP. et al. Early and sustained survival benefit associated with statin therapy at the time of percutaneous coronary intervention. Circulation 2002; 105: 691-6.
  CrossrefPubMedGoogle Scholar
• 30 Rittersma SZ, de Winter RJ, Koch KT. et al. Preprocedural C-reactive protein is not associated with angiographic restenosis or target lesion revascularization after coronary artery stent placement. Clin Chem 2004; 50: 1589-96.
  CrossrefPubMedGoogle Scholar
• 31 Rosenson RS, Koenig W. Utility of inflammatory markers in the management of coronary artery disease. Am J Cardiol 2003; 92: 10i-18i.
  PubMedGoogle Scholar
• 32 Buffon A, Liuzzo G, Biasucci LM. et al. Preprocedural serum levels of C-reactive protein predict early complications and late restenosis after coronary angioplasty. J Am Coll Cardiol 1999; 34: 1512-21.
  CrossrefPubMedGoogle Scholar
• 33 Walter DH, Fichtlscherer S, Sellwig M. et al. Preprocedural C-reactive protein levels and cardiovascular events after coronary stent implantation. J Am Coll Cardiol 2001; 37: 839-46.
  CrossrefPubMedGoogle Scholar
• 34 Gomma AH, Hirschfield GM, Gallimore , Jr. JR. et al. Preprocedural inflammatory markers do not predict restenosis after successful coronary stenting. Am Heart J 2004; 147: 1071-7.
  CrossrefPubMedGoogle Scholar
• 35 Segev A, Kassam S, Buller CE. et al. Pre-procedural plasma levels of C-reactive protein and interleukin-6 do not predict late coronary angiographic restenosis after elective stenting. Eur Heart J 2004; 25: 1029-35.
  CrossrefPubMedGoogle Scholar
• 36 Chan AW, Bhatt DL, Chew DP. et al. Relation of inflammation and benefit of statins after percutaneous coronary interventions. Circulation 2003; 107: 1750-6.
  CrossrefPubMedGoogle Scholar
• 37 Walter DH, Fichtlscherer S, Britten MB. et al. Statin therapy, inflammation and recurrent coronary events in patients following coronary stent implantation. J Am Coll Cardiol 2001; 38: 2006-12.
  CrossrefPubMedGoogle Scholar
• 38 Schillinger M, Exner M, Mlekusch W. et al. Acutephase response after stent implantation in the carotid artery: association with 6-month in-stent restenosis. Radiology 2003; 227: 516-21.
  CrossrefPubMedGoogle Scholar
• 39 Cipollone F, Marini M, Fazia M. et al. Elevated circulating levels of monocyte chemoattractant protein- 1 in patients with restenosis after coronary angioplasty. Arterioscler Thromb Vasc Biol 2001; 21: 327-34.
  CrossrefPubMedGoogle Scholar
• 40 Bhatt DL. Inflammation and restenosis: is there a link?. Am Heart J 2004; 147: 945-7.
  CrossrefPubMedGoogle Scholar
• 41 Zairis MN, Ambrose JA, Manousakis SJ et al. The impact of plasma levels of C-reactive protein, lipoprotein (a) and homocysteine on the long-term prognosis after successful coronary stenting: The Global Evaluation of New Events and Restenosis After Stent Implantation Study. J Am Coll Cardiol 2002; 40: 1375-82.
  CrossrefPubMedGoogle Scholar
• 42 Marculescu R, Mlekusch W, Exner M. et al. Interleukin- 1 cluster combined genotype and restenosis after balloon angioplasty. Thromb Haemost 2003; 90: 491-500.
  Article in Thieme ConnectPubMedGoogle Scholar
• 43 Rahel BM, Visseren FL, Suttorp MJ. et al. Preprocedural serum levels of acute-phase reactants and prognosis after percutaneous coronary intervention. Cardiovasc Res 2003; 60: 136-40.
  CrossrefPubMedGoogle Scholar
• 44 Cook DG, Shaper AG, Pocock SJ. et al. Giving up smoking and the risk of heart attacks. A report from The British Regional Heart Study. Lancet 1986; 2: 1376-80.
  PubMedGoogle Scholar